Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,056.00 / $4,466.00 / $9,081.66	Facility		$1,056.00	$4,466.00	$9,081.66
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,340.64 / $4,899.00 / $12,278.73	Facility	50	$1,340.64	$4,899.00	$12,278.73
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $82.22 / $82.22 / $226.89	Facility	52	$82.22	$82.22	$226.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.89 / $32.89 / $90.75	Facility	53	$32.89	$32.89	$90.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.72 / $212.64 / $624.11	Professional		$136.72	$212.64	$624.11
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $207.82 / $339.35 / $816.67	Professional	50	$207.82	$339.35	$816.67
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $19,180.06 / $19,180.06 / $19,180.06	Facility		$19,180.06	$19,180.06	$19,180.06
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,800.00 / $8,639.91 / $11,331.00	Facility		$2,800.00	$8,639.91	$11,331.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $320.49 / $571.87 / $873.25	Professional		$320.49	$571.87	$873.25
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $480.73 / $870.05 / $1,309.88	Professional	50	$480.73	$870.05	$1,309.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.69 / $317.10 / $724.69	Professional		$164.69	$317.10	$724.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $440.09 / $583.38 / $599.63	Professional		$440.09	$583.38	$599.63
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,122.32 / $7,051.37 / $14,067.32	Facility		$2,122.32	$7,051.37	$14,067.32
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,640.70 / $7,289.54 / $15,426.91	Facility	50	$2,640.70	$7,289.54	$15,426.91
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $19,180.06 / $19,180.06 / $24,299.59	Facility		$19,180.06	$19,180.06	$24,299.59
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $664.02 / $4,403.42 / $9,543.51	Facility		$664.02	$4,403.42	$9,543.51
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $2,543.00 / $5,516.78 / $12,278.73	Facility	50	$2,543.00	$5,516.78	$12,278.73
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $82.22 / $82.22 / $226.89	Facility	52	$82.22	$82.22	$226.89
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $32.89 / $32.89 / $90.75	Facility	53	$32.89	$32.89	$90.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $136.72 / $237.70 / $775.11	Professional		$136.72	$237.70	$775.11
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $207.82 / $303.63 / $775.11	Professional	50	$207.82	$303.63	$775.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $5,438.19 / $5,714.70 / $7,078.91	Facility		$5,438.19	$5,714.70	$7,078.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $1,147.20 / $1,233.90	Professional		$3.00	$1,147.20	$1,233.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $167.63 / $340.47 / $724.69	Professional		$167.63	$340.47	$724.69
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $149.94 / $373.80 / $766.51	Facility		$149.94	$373.80	$766.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $149.94 / $381.30 / $417.78	Professional		$149.94	$381.30	$417.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,334.00 / $2,824.00 / $5,678.00	Facility		$1,334.00	$2,824.00	$5,678.00
United Facility/Professional Professional Modifier Low / Median / High Price $444.59 / $580.39 / $959.74	Professional		$444.59	$580.39	$959.74